by The Editorial Board, USA TODAY

by The Editorial Board, USA TODAY

For most people who get the flu, the penalty can be several days of misery. But for thousands of Americans every year, the virus is a death sentence.

Particularly vulnerable are the very young and the very old. Although this year's outbreak is beginning to wane nationally, the strain is killing seniors at the highest rate (116 deaths per 100,000 cases) since age-related tracking began in 2005, a Centers for Disease Control and Prevention epidemiologist said Friday.

Because so many of the most susceptible people are in hospitals and long-term care facilities, it's imperative that health care workers not spread the infection. In too many places, however, too many workers are balking at flu shot requirements, with potentially tragic consequences.

USA TODAY's Janice Lloyd reported recently that two children at Children's Hospital in Philadelphia couldn't receive the vaccine several years ago because they were being treated for cancer. Both caught the flu in the hospital and died.

This suggests a simple rule for nurses: You can refuse to get a flu shot. You can come into contact with patients. But you can't do both.

"It's not your inalienable right not to get a vaccine if you're helping care for vulnerable patients," Paul Offitt, chief of infectious diseases at the Philadelphia hospital, told Lloyd.

For years, health officials tried persuasion, urging health care personnel to get vaccinated every year. It worked, but not as well as you'd think among people whose most important job is caring for the sick: The CDC says the vaccination rate in hospitals that don't require shots is about 68%. But in hospitals where the vaccination is required, the compliance rate is more than 95%.

Over the past several years, hundreds of hospitals and health systems around the country have started requiring employees who come into contact with patients to get vaccinated. According to Alexandra Stewart, an attorney who teaches health policy at George Washington University, 21 states have also adopted laws that require at least some health workers at certain facilities to get vaccinated.

That has sparked a backlash among a fairly small group of nurses and others who bristle at being told they have to get the vaccine. In some cases this flu season, hospitals have fired nurses who refused to be vaccinated or, in at least one case, to wear a surgical mask.

The mandates aren't ironclad. Hospitals typically offer exemptions for anyone who can demonstrate a religious objection or a legitimate health-related reason to avoid vaccination. (Serious reactions to the flu shot are extremely rare - fewer than 5 in a million, CDC says.)

But some health workers have refused the vaccination on the grounds that they have a personal objection to putting any foreign substance in their bodies. That flimsy objection hardly outweighs patients' rights not to be unnecessarily exposed to a virus that could kill them.

Hospitals, health officials and state legislators are right to draw the line in favor of protecting patients, not health care workers' jobs. If the employees disagree, they're free to go into another line of work.